Individual
MR. TROY JONATHAN WENDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.D.
Contact information
Practice address
225 S TACOMA WAY, TACOMA, WA 98402-1295
(253) 272-8856
Mailing address
225 S TACOMA WAY, TACOMA, WA 98402-1295
(253) 272-8856
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000332
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5040373
DSHS OFFICE
WA
01
—
5040381
DSHS TROY
WA
Enumeration date
11/13/2006
Last updated
07/08/2007
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